How much rates vary
Facilitymedian $200 · 10th to 90th $155 to $219Professionalmedian $135 · 10th to 90th $100 to $234
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Professional | None | $125.89 | $125.89 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Facility | None | $134.90 | $134.90 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $134.90 | Professional | None | $100.00 | $100.00 | $134.90 |
Kaiser Permanente Setting Professional Modifier None Typical Low $158.49 Median $457.09 Typical High $588.84 | Professional | None | $158.49 | $457.09 | $588.84 |
Moda Health Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $213.80 | Facility | None | $125.89 | $158.49 | $213.80 |
Moda Health Setting Professional Modifier None Typical Low $125.89 Median $194.98 Typical High $213.80 | Professional | None | $125.89 | $194.98 | $213.80 |
Pacific Source Setting Facility Modifier None Typical Low $165.96 Median $199.53 Typical High $208.93 | Facility | None | $165.96 | $199.53 | $208.93 |
Pacific Source Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $208.93 | Professional | None | $199.53 | $199.53 | $208.93 |
Providence Setting Facility Modifier None Typical Low $125.89 Median $134.90 Typical High $213.80 | Facility | None | $125.89 | $134.90 | $213.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $204.17 | Professional | None | $79.43 | $100.00 | $204.17 |
Regence BlueShield Setting Facility Modifier None Typical Low $169.82 Median $331.13 Typical High $812.83 | Facility | None | $169.82 | $331.13 | $812.83 |
Regence BlueShield Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $234.42 | Professional | None | $213.80 | $234.42 | $234.42 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $436.52 | Facility | None | $331.13 | $331.13 | $436.52 |
United Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $194.98 | Professional | None | $91.20 | $100.00 | $194.98 |
8 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $63.10 | $63.10 | $63.10 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $25.12 | $25.12 | $25.12 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $18.62 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $12.59 |
Where Oregon sits
The same service costs 3.9 times more in Kansas than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Oregon· 17th of 51
$166
KS $389NJ $100
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.